Diagnostic significance of tumor markers CA125 and HE4 in suspected ovarian cancer

Abstract

In developed countries, ovarian cancer ranks third in prevalence among malignant diseases of the female genital area; the peak incidence occurs at the age of 55-58 years. An increased risk of ovarian cancer is observed in women with early onset of menstruation and late menopause; women whose first pregnancy occurred at the age of under 19 and over 35 are also at risk. The use of hormonal contraceptives can almost halve the risk of this malignant process. Due to the absence of severe clinical symptoms in every second case, this pathology is detected already at stages III-IV, which explains the rather low survival rate. With timely diagnosis, relapse can be avoided in 73-76% of cases due to the effects achieved in the conduct of chemotherapy. CA125 and HE4 are among the tumor markers of choice, the level of which is checked for suspected ovarian cancer. To assess the risk of the process malignancy, the ROMA index is used. This index represents a mathematical model, the calculation of which takes into account the absolute values of CA125 and HE4, as well as the menopausal status of awoman. Determining the concentration of tumor markers in dynamics is also used to assess the effectiveness of the treatment. At the same time, it should be noted that an increase in the content of tumor markers does not always indicate the presence of a malignant process; this picture can be observed with endometriosis, polycystic ovary syndrome, and neoplasms affecting the peritoneum, pleura, pancreas, and liver.